HomeMy WebLinkAbout1997-009070 - addition PERMIT
CITY OF ORONO PERMIT TYPE: ,�: —
, 2750 Kelley Parkway- FO. Box 66 =-�::==.�'��°`='
Crystal Bay, Minnesota 55323 Permit Number: i:;�:i�a;�� ��_r
(612) 473-7357 Date Issued: ;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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, CONTRACTOR: -- ��z��,-� � _ - -� - .� . . OWNER:
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APPLIC NTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE
1
Total Fee: $ ��� ���' Date Received:
Entered By: -;, Pernut#: C��,'��:
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CIT�OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR ONTRACTO�
JOB SITE ADDRESS: �5�, ��x �-�„�.—, ZIP� SSi9/
NAME OF OWNER: n�c,,r.., w_ P.s,«�,r PHONE: (home) y�j -Safv
(work) �7 -s�-�/
MAILING ADDRESS: ,��„ ,-�y c-,L,�; CITY: �,w,�a ZIP: 5539!
CONTRACTOR: ,���,�„–f, �� PHONE: 9�,_,ay`
CONTACT PERSON:_�,,��.;� Y,�,,,,�,y MOBILE/PAGER: 9G9 •�S,L
MAILING ADDRESS: ,y3g r,,, ��_{,,� ,e,� CITY: ,r,�,,,,��.�,�c,r.a ZIP: S53v5
STATE LICENSE: # 899ti
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �aJ /yx�z' ����n �� 2,.-.�,�, ��
.�iLd r-�t�- G�tc.l�✓�Y'� - ��I�i/ G„ e w� .tiT .vld Q,�_.�Ti�.t��_�
�,,c,v ,��_ ;i�o G/�trlGe: a� 1��X.�
STORIES: � SQ. FEET OF EACH FLOOR: �s�•�,w�' ���r����'ni�) 9�
NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. L DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ St,���
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: �/,� � DATE: Z�r.s/�
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
6
Sec.13.04 RIGHTS OF St1BJECTS OF DATA
Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or co�dendal data concerning himself shall
be infocmed of: (a)the purpose and incended use of the requested data within the collecting'state agency, polidcal subdivision,or statewide system;
(b)whe[her he may refuse or is legally required ro supply the requested data;(c)any l�own consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the idendry of other persons or endties authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesaeative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the noace required under chis subdivision in the individual income tax or properrv tax refund
instrucdons instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored dxta on individuals, and whether it is classified as public, private or co�denaal. Upon his further request, an individual who is the subject
of stored private or public data on individuals shall be shown the data without any charge[o him and, if he desires, shall be informed of the content
and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for
six months thereafrer unless a dispute or action pursuant to this secdon is pending or addidonal data on the individual has been collected or created.
The responsible authoriry shalt provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making, cerafying, and compiling the copies.
The responsibie authoriry shall comply immediately, if possibie, with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that[ime,he shal(so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Sarurdays,
Sundays and leeal holidays.
Subd.4. Procedure when data is not accu:ate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shafl notify in wricing the responsible authoriry describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correcc the data found to be inaccurate or incomplete and attempt to notify past recipienrs of
inaccurate or incomplete data, including recipients named by the individual; or(b) notify the individual that he bztieves the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The detzrminadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating to
contesced cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we wouid like to inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish cercain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the Ciry deny the pernut or license.
3. The information may be shazed with other local, state or federal agencies to the extent necessary to process
the pernut or license.
4. If your requested pernut or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
,i,�;�; ,—.c�u�c.- �T�,� _
First �Siddle Lasc
Z�f'?9 rNC•tlw.e.ve[7 iV/t.liS �d0
Address
7-�tit ,.�t,v S�'ki5 9SG-/d?'� _
Cih, State Z�p Phone
I understand my rights as stated above.
���—� `—� a'�
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I S�Zc� F o X s-t'(1,c—ET
PID:
DESCRIPTION OF WORK: �q d�i�oiv
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ZONING REVIEVS� BY: DATE APPROVED: 6-/(�-5�
BUILDING REVIEW BY: DAT'E APPROVED: (�-/v•9�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes �' No SEWER CONNECTION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: /?/Z-1�
Fire Department: n, �i4-� Post Offce: (�-i�C: School District: p�Z.t�o
Lot Area: Sq.ft. Acres Z•25 1 Width t 2�tG��-�tR Depth —
Survey Submitted: Yes X. No Date of Survey: (2 —�!o
Proposed Setbacks:
Front (�e): 1�15 � Right Side: !7�� �=
Rear (Street): ZZS� Left Side: (�.y w
Adjacent Structures: A'T'r��-D Wetland: N�
Building Height: Def. Hgt. C9 •IL. Peak Hgt. (�.�c•
Lot Coverage: hl �A
Grading: Staff Approval Date: �-�0-y10•lL By:�4 • Council Approval Date:
Septic: Staff Approval Date: N�f� By:
Zoning File: # Z Z3 Z Resolution: # Resolution Date: Z� i �
Shoreland District:
Avg. Setback: Bluff Setback:
' n Existing Proposed
,�1,1� Hardcover: 0-75'
�� 75-250'
250-500'
SJO-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
BUII..DING REVIEW CHECK LIST
uBc: 2-3 co�vs�rxucTTo�r �E: vr�
Sq Foota�e S Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
C =
TOTAL
Estimated Construction Value: $ SZ,000��
Inspections Required: Work Requiring Separate Permits:
Site � _� Piumbing Fire
Hardcover Removal _� Mechanical Water Connection
�_ Footing Septic Sewer Connection
_�o Framing Fireplace Lawn Imgation
K Insulation (Masonry) Other
�_ Wall Board (Mfg.) Well (State Pemut)
o� Final Grading/Filling n Electrical (State Permit)
Other
REMARKS (Pi 1 HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
= Access Approval: Date By�
REVIARKS(TO BE NOTED ON PERi'�1IT):
27
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Reinstall potio door.
Aeins,all double casement window.
21' 10 5/8"
15' 0 5/16"
B' 7 1/2"
. +
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Remo�e potio door and mo�e passage as drawn_
A�II���7CII�I� ��a�lLlE = 7�/4
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EXHAUST AN O O
�� DIR Y OUTSIDE
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' PROVIDE PUMP AND/OR ��
PI,�G ACCES'�
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5' �" �' 1� 1r2>> 6� �>> I
Ceramic Tile Shou aer 6-� Whirlpool Tub
Co�-��ert existing masLer closet to shouaer and toile�, ruom_
B��C � �CC� /��� o �I �D �>
�R-�8 Fiberglass Batt Insulation
� nstall One Turbine Vent on Roof
�]��'��[I[.,o �t�](,](, (���J�� J�J.�(�`�'���/���J°�j'�i[ / 60 Mil_ EPDIVI Rubber I�embrane Glued to Backer Board
J
����� o ��� ����a�s 1/2" Backer Boord
3/9" CDX Roof Decking
1x� Perpendicular t,o Joist,s for Cont,inuous Airspace
2x12 SPF Joists 16" OC � " �,,,,,.� P���+ P�e/z- �vo�
Accent & Fascia BlocKed & Flashed to �latch Exist,ing -- -- -- -- -- --
Inst,al_ Wall Uent,s t,o �latch Exist,ing Block Joist,s at, Il�idspar
Accent & Fascia Blocked & Flashed to I�at,ch Existing ��5/8" Dr��u�all��-��i1_ Vapor Barrie�
Headers for Window and Patio Door Are to Be Doubled �x1�
3/9" Stucco O�er Wire Lath & 3B# Felt
�v 2x6 Stud Wall 16" OC
R-21 Fiberglass Batt Insulat,ion
Flash Behind Coping
6-I�i1. Vapor Bamier
E 5/8" Dryu�all
Flagst,one Coping to �latch Existing
Bitumin-l�odified Urethane Waterproofing Applied to Surface
S1ope Finish Grade Away from House �Cx1B Treated I`Jludsill in the Plane �uith the Fin�sh�d Slab
Slope Top of Footing �uith INortar � �
_��� -����.
� � `}" Reinforced Concrete Slab
2" Sand Base
6-�lil Pol�ethylene I�oisture Barrier
9" Compact,ed Gravel
� - = ��� - PVC Heot Duct
2" Closed-Ce ll Rigid Insulation
42" MIN Frost Footina� �9" �rain Tile Tied Into Houses Existing Drain Tile
Compacted Gra�el
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1�Al�l[S1El� ]�lE���lE1�VCClE �l�l��]���JE�➢ lEL]E�7�'���I�e �lE�7f� �cC�ILIE _ ]L/�
ll��� ]P�� �tr�e��4 ]�Il��IEIL�1�1�
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Addition exferior is f,� ba s�ucco Eo match body of house.
ascia and accent Lrim on ❑ddition Eo mof.ch current house-
einstall current pat,io door ond dauble casement window in addit,ion.
ddition to rear of west wing_
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Addition to be bui1L on slab withouf, a crawl space. ;;;;;;;;;;;;;;;;;;;;;;;;;
Addik.ion foundai,ion t,o st,ep down from crawl space footing f,o basemenL footing. ::
.. .............. .........................
]�AI�IE�IEI� I�IE�di�lEl�cCIE �l�li��1���lEII� lElLlE�I�'II'II�1�Ta ��L[T'�lH[� �C��lLIE _ �/�
]�l��lE1L���
ll��� IF��s Str���tr
�����o �� ����fl
DATE TIME
CITY OF ORONO CALLED IN �" i'- % 7
INSPECTION NC��ICE SCHEDULED �� it- /� 7 �i ' - r,
PERMIT N0. jC I C-� COMP�ETED /�_ �
ADDRESS -_ ��'�_f • ". < �
OWNER _i��-/'� � ' CONTR.����'z��,-�ri�z Uz
TELEPHON E NO. ���C% � /��`� ��
� DESCRIPTION _ �Zc',-i�t _t' � �
� �1 FOOTING 11 MECHANICAL RI 18 EXCAV/GHADING/FILLING
� 02FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PiiOGRESS
�` 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
W 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PIUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d �WORK SATISFACTORY:PROCEED
W PROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR — CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance.473-7357
OwnerlContya�ciqr ite:
�
Inspector. -- ��
White Copyllnspector's File Canary CopylSite Notice
D/AT�E TIME
CITY OF ORONO CALLED IN � ��o� �
INSPECTION NOTICE SCHEDULED '� q.`���
PERMIT NO. �� �� COMPLETED �
ADDRESS S �'�l ��
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� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAOING/FILLINCi
y 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLAN�S
Q 03 INSULATI � 24/25 WOOD BURNER/FIHEPLACE 34 TREE REMOVAL
Z 04 WALL . 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
�' 07 DEMO�ITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMa—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HAfiD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL RETURN
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❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for th ext i s ction 24 hours in advance.473-7357
OwnerlContr cto ite:
Inspector.
White Copyllnspeclor's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN �D �-/
INSPECTION NOTICE SCHEDULED '7 } dZ f; 3 c`�
PERMIT NO. COMPLETED � �
ADDRESS �s �- �' �� f'-� S7�
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TELEPHONE N0. �� � �s �'� �,d��
� DESCRIPTION �-�1'��-- /CC_d�',,�'L--
� Ot FOOTING �i/ 11 MECHANICAL RT�`��/( 7 �'r �g�(CAV/GRADING/PIWNG
�Q FRAMING �O�I�� 13 MECHANICAL FINAL �, 19 LAKESHORE/WETLANDS
Q 03 SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. �/ Q�Y1 12 WATER HOOK-UP 17 SITE INSPECTION
= OS FINAL �-3�F I—R�� 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DE AL �� 15 SEPTIC INSTALL. 22 FOLLOW-UP
2 09 PLUMBING RI �/b0 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 2$CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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OO �' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. �- pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION iSSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next spection 24 hours in advance.473-7357
Owner/Contr�si :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice